Can knitting structure affect dilation of polyester bifurcated prostheses? A randomized study with the use of helical computed tomography scanning

Goëau-Brissonnière, Olivier A. MD, PhD
Qanadli, Salah D. MD
Ippoliti, Arnaldo MD
Pistolese, Giuseppe R. MD
Coggia, Marc MD
Pollock, John G. MD

Paris, France; Rome, Italy; and Glasgow, Scotland
From the Division of Vascular Surgery (Drs Goëau-Brissonnière and Coggia) and the Department of Radiology (Dr Qanadli), Ambroise Paré University Hospital, Boulogne-Billancourt, and René Descartes University; Cattedra di Chirurgia Vascolare (Drs Ippoliti and Pistolese), Università di Roma "Tor Vergata"; and the Division of Vascular Surgery (Dr Pollock), Royal Infirmary.

Competition of interest: nil.

Reprint requests: Dr Olivier A. Goëau-Brissonnière, Service de Chirurgie Vasculaire, Hôpital Ambroise Paré, 9 avenue Charles de Gaulle, 92104 Boulogne-Billancourt Cedex, France.

Visit the Journal's web site at www.mosby.com/jvs for the raw data from this study.

Submitted May 17, 1999; accepted Jul 15, 1999.

Journal of Vascular Surgery 31(1):p 157-163, January 2000.

Purpose:

The aim of this study was to prospectively evaluate the postoperative dilation of two types of knitted polyester arterial prostheses with the use of helical computed tomographic scanning.

Methods:

Thirty-four patients who underwent aortoiliac or aortofemoral bifurcation grafting were randomized to receive a collagen-sealed warp-knitted polyester graft (n = 16 patients) or a gelatin-sealed Köper-knitted polyester graft (n = 18 patients). Alterations in size of all parts of the grafts were evaluated by helical computed tomographic scanning at postoperative day 8, at 3 months, and at 6 months.

Results:

On postoperative day 8, the mean dilation of the Köper-knitted grafts was 18% ± 8% for the stem and 15% ± 12% for the limbs. At the same time period, the mean dilation of warp-knitted grafts was 27% ± 13% for the stem and 33% ± 18% for the limbs. No increase in graft dilation was observed at 3 and 6 months. Despite the wide range of values among patients with the same graft type, at each time interval, the Köper-knitted grafts dilated significantly less than the warp-knitted grafts (P < .05).

Conclusion:

In this randomized study, helical computed tomographic scanning was an accurate technique with which to assess graft dilation. For a 6-month follow-up interval, the Köper-knitted polyester structure dilated less than the warp-knitted structure. Longer-term serial scans should allow a better understanding of the clinical significance of graft dilation.